Teratoma mediastinal grande asociado a derrame pleuropericárdico severo por perforación de ambas estructuras / Large mediastinal teratoma associated with severe pleural pericardial stroke due to perforation of both structures

Se presenta el caso clínico de un paciente de 21 años de edad, quien ingresa en el Servicio de Cardiología del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres por presentar pericarditis aguda de evolución tórpida. Al realizarle la tomografía axial computarizada del mediastino se diagnosticó un teratoma asociado a derrame pleuropericárdico severo por ruptura de ambas estructuras. Fue intervenido con circulación extracorpórea y se confirmó el diagnóstico histológico

The case report of a 21 years patient is presented who is admitted in the Cardiology Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital due to acute pericarditis of torpid course. When the computerized axial tomography of the mediastinal cavity was carried out, a teratoma associated with severe pleural pericardial stroke due to rupture of both structures was diagnosed. He was treated with extracorporeal circulation and the histologic diagnosis was confirmed

A Case of Acute Purulent Pericarditis with Pericardial Performation by Esophageal Foreign Body

Purulent pericarditis is an infrequent but fulminant and frequently lethal disease. Purulent pericarditis tends to occur as direct extension of bacterial pneumonia or empyema in past. In recently, purulent pericarditis tends to occur in adult via contiguous spread from an early postoperative infection after thoracic surgery or trauma, infection related to infective endocarditis, extension from a subdiaphragmatic suppurative source, and hematogenous spread during bacteremia. Endogenous causes of purulent pericarditis are frequently characterized as esophageal perforations. Common causes of esophageal perforations related to purulent pericaditis which usually develop in association with mediastinitis, pneumonia and empyema include corrosive esophagitis, complication after esophageal and tracheal instrumentation and Boerhaave's syndrome. There is very little reference to the development of pericarditis in associated with esophageal perforation which does not directly communicate with the pericardium. while, although most uncommon, it is well documented that the esophagus can perforate directly into the pericardium and produce pericarditis. We experienced a case of acute purulent pericarditis after esophageal and pericardial perforation by a small fish bone in a previously healthy man. The patient was treated successfully with systemic antibiotics and pericardiotomy.